Need help with bloodwork, decisions, lifestory included

faildoc

New Member
Hi.
I need your help because i dont know how to proceed with my problem.

Infos about me:

Male 38 from Germany
Height: 178cm
Weight: 107kg 236 pounds

When i was a youngster and a young adult i was always lean and athletic.
With 18 i started bodybuilding/weight lifting, at 20 i used some prohormones and with 22 i had a cycle with primobolan for 8 weeks with 100mg/w. My PCT was not that great was nolvadex if i remember correctly but everything regarding sex drive and genital worked after quiting the cycle.
At the age of 23/24 i had a really demanding job where i got mobbed and was put under really hard stress.
This was the kick of for the guy i became past then.
I stopped working out and socializing, started playing huge amounts of time at the computer, with other words fleeing from the real world.
Starting from 83kg and athletic build i was a flubby and fat guy within a year weighing 125kg then.
I think the job pushed me of my track and i had a mild depression because of that hostile atmosphere.

The fatty period lasted till 2016, i was married for 6 years and my own house and two kids. In this year i decided i had to make a change and push myself to become my old self again.
I started to ride to work by bicycle (cyclocross) with amounts of 30kms total per day and started to work out again.
Till the end of 2016 i lost about 10kg only from doing sports, i didnt change my caloric intake but ate healthier.
Beginning with 2017 i broke vertebra in my spine because of a bicycle accident and gained all the weight back on which i lost in 2016.
When i recovered i started again and in the summer of 2018 i broke the barrier of 100kg.

At this time i was using some tribulus terrestris, tongkat ali and the normal supplements like zinc, magnesium etc.
I even started attending boxtraining 1 or 2 times a week.

And then it happened in autumn 2018, i realized i got fatigued and exhausted very easily. My gym recovering times skyrocketed. It got harder to motivate myself and so i had peroids of up to two weeks where i did no sport only to have a peroid of two weeks where everything was back to normal and on and on.
My sex drive plummeted into nowhere and my daily masturbation went to once or twice a week. Fatigue got back at me and my mood took a nosedive because of this. At the time of christmas i stopped working out till today.

I made an appointment with my gp and told him following symptomes:

lack of concentration (mainly at my job as an office clerk)
memory is not as good as normal
no drive for sex, sports, socializing whatever
weight is already increasing to 107kg because of not working out and eating too much to highten my mood
more twitchy then normal especially with the kids
erections not as hard
no morning wood
sleep so so, sometimes good sometimes not so good, have to pee often at night but i drink a lot in the evening (water, no alcohol)

He made a thyroid protocol and total testosterone and i have my TSH from bloodwork from last september in 2018

16.09.2018
TSH 2,04 mU/I Reference 0,30-4,00
16.01.2019
TSH 2,49 mU/I Reference 0,30-4,00
Free T3 4,08pmoI/I Reference 3,00-5,40
Free T4 11,3pmoI/I Reference 10,2-17,9
Total testosterone 496 ng/dl Reference 240-870

My GP told me my total t is alright and my TSH also.
My wife told me that my TSH is slightly elevated (she has hashimoto so she knows many things about thyroid and stuff)

After that i made an appointment at a urologist.

He made an ultrasonic test of my testicles and my prostata. Everything was ok. Being asked about my problems he declined and he told me that this was not covered by my insurance and i should talk to my GP again.

So not really satisfied with the appointment i made another at another urologist.
In the meantime i went to a laboratory and paid for the necessary bloodtests by myself.

The results are as follows:


referenz = reference

07.02.2019
TSH 1,93mU/U Referenz 0,27-4,20
DHEA-S 280,0µg/dl Referenz 88,9-427,0
FSH 4,0 IU/I Referenz 1,5-12,4
LH 3,19 IU/I Referenz 1,70-8,60
Prolactin 8,07 ng/ml Referenz 4,04-15,20
total testosterone 15,9 nmol/l Referenz 12,0-30,0
SHBG 41,4 nmol/l Referenz 18,3-54,1
free androgen index (FAI) 38,5 Referenz 35,0-92,6
estradiol (E2) 19,7 pg/ml Referenz 11,3-43,2
Somatomedin C 179,6 µg/l Referenz 74,0-240,0

deflated by those results i went to the urologists and told her my story (same as i wrote down here) and showed here the bloodwork.

Her answer was: everything fine and she thinks its depression related or a beginning of a burnout.

So now i am here and dont know how to proceed from here.

On monday i have an appointment at a endocrinologist and hope the she (a woman again) is more open for my problems.

my personal evaluation is that either my total testosterone is too low for my age and therefore my free testosteron is too low too or i am latent hypothyroid but i am not educated enough to read my bloodwork properly.

Maybe someone here at reddit can help me out and evaluate my values right and give me a hint or two.

Thank you for your time and help :-)

P.S. Sorry for the strange english but its only my second language.
 
I have some concerns, Free T was never measured and SHBG while not high wouldn't be the first time I've seen sub-optimal Free T at that SHBG level. The reason is because the strength of the binding force of SHBG differs from person to person and is why we must measure Free T, androgen index isn't very useful, but if accurate would put all your free hormones right at the bottom of the ranges.

Your Total T is 458 and SHBG 41 towards the high end, I expect Free T to be sub-optimal. I'm on TRT and need Free T at the top of the ranges to relieve all symptoms of low testosterone, when my Free T is midrange, I experience all low testosterone symptoms.

Low testosterone can cause depression, knowledge in male sex hormones isn't an area doctors have paid attention to until now, few doctors are knowledgeable enough to diagnose and treat you.
 
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A calculated value for your free testosterone is about 8 ng/dL, or under 0.3 nmol/L. In general it seems as though some guys will start to show symptoms of low T when calculated free T drops below 10 ng/dL or so. In other words, it's quite possible that low T is your problem. In addition, according to some studies your total testosterone is about average for someone 70-80 years old.

I agree with what @Vince said about trying Clomid before TRT. If it works it will keep your body functioning more normally than TRT would.
 

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